Who is currently recommended to receive an updated COVID-19 vaccine in the U.S.?

FDA has authorized updated vaccines for high-risk groups; CDC has not finalized broad guidance as of October 2025. AAP recommends infants 6–23 months and selected older children; ACOG recommends vaccination in pregnancy and lactation.

Why are some shipments delayed and coverage inconsistent?

Without finalized CDC recommendations, insurers and federal programs like Vaccines for Children face barriers, creating patchy access and potential out-of-pocket costs.

Which variant do the 2025 updates target?

The 2025 formulation targets LP.8.1 (an offshoot of JN.1), per FDA filings.

Can healthy children still get vaccinated?

Yes, but coverage may be limited until CDC guidance is finalized; families may face private-pay costs in the interim.

Infectious Diseases

COVID-19 Vaccination Guidelines — United States (August 2025, Updated October 2025)

Q: What is COVID-19 Vaccination Guidelines — United States (August 2025, Updated October 2025)?

The FDA’s latest approvals, CDC’s stalled guidance, and AAP/ACOG recommendations on COVID-19 vaccination as of October 2025.

2025-08-28

COVID-19 Vaccination Guidelines — United States

(August 2025, Updated October 2025)

Update — October 2025:
As of October 3, 2025, the CDC has not yet issued final guidance on COVID-19 vaccination despite FDA approvals and ACIP recommendations. This has frozen vaccine shipments under the federal Vaccines for Children program and created major access barriers for both children and adults.

Intro

As of late August 2025, COVID-19 vaccine policy in the U.S. is fragmented.
The FDA, CDC, AAP (pediatrics), and ACOG (obstetrics) are not fully aligned, creating confusion over who should be vaccinated, when, and at what cost.

Key Points

FDA: Approved updated vaccines targeting the LP.8.1 strain (offshoot of JN.1) for limited groups.
CDC: Narrowed recommendations to high-risk patients; advisory committee replaced. As of Oct 2025, still no final guidance issued.
AAP: Recommends vaccination for infants 6–23 months, and for older children at risk.
ACOG: Recommends updated vaccination for all pregnant and lactating patients.
Coverage: Insurance and program access remain patchy without CDC sign-off; private cost ~$140+ per dose.

FDA Approvals (Aug 27, 2025)

Pfizer-BioNTech (Comirnaty): 65+; ages 5–64 with ≥1 underlying condition.
Moderna (Spikevax): High-risk individuals aged 6 months+.
Novavax: High-risk individuals aged 12+.

CDC Position

No longer recommends universal vaccination.
“Shared clinical decision-making” for healthy children and adults.
Advisory committee (ACIP) removed in June 2025; new members pending.
Oct 2025: No finalized guidance → VFC program frozen.

AAP Position (Pediatrics)

Infants 6–23 months: Strong recommendation to vaccinate.
Ages 2–18: Recommend if high-risk, unvaccinated, or living in congregate/high-risk settings.

ACOG Position (Pregnancy)

Recommends updated COVID-19 vaccine:
- At any trimester of pregnancy.
- During postpartum or lactation.

Coverage and Costs

Without CDC endorsement, insurers may not cover all populations.
Private sector cost: estimated at ~$140 per dose.
Vaccines for Children (VFC) program on hold pending CDC guidance.

Risks / Benefits / Prognosis

Vaccines remain strongly protective against severe disease in high-risk groups.
Benefit for healthy children and young adults is debated.
Ongoing political conflict and CDC delays undermine clarity and access going into winter 2025–26.

FAQ

Q: Can healthy kids still get vaccinated?
A: Yes, but coverage may be limited and many families face out-of-pocket costs until CDC guidance is finalized.

Q: Do pregnant women qualify?
A: Yes. ACOG recommends vaccination during pregnancy, postpartum, and lactation.

Q: Which variant do the new vaccines target?
A: LP.8.1, an offshoot of JN.1.